History—Sample Questions

Sociodemographic, Obstetric, Medical, and Life-Style Factors

What vitamins,minerals,or other supplements are you taking?How much? How often? Why?

Have you had anemia,"low blood," or "low iron"?

Are you breastfeeding now?

Are you planning to become pregnant in the next year?

Weight Status

How do you feel about your current weight?

Have you ever been underweight? Overweight? What,if anything,did you do about it?

If an eating disorder is suspected, ask: Does it bother you toknow that you are going to be weighed? If yes, When you know youwill beweighed,do you ever eat less? Force yourself to vomit? Uselaxatives or diuretics? Exercise a lot?

Have you recently gained or lost weight? How much? How fast? Wereyou trying to lose weight? If yes, Using what type of plan?

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